Organization
BAYCARE MEDICAL GROUP INC
Active
Other names
Breast Surgery @ Van Dyke
Organization subpart
No
Provider details
NPI number
Authorized official
LYNDA GORKEN (VP, PFS)
(727) 281-9202
Entity
Organization
Contact information
Practice address
4211 VAN DYKE RD STE 200, LUTZ, FL 33558-8005
(813) 264-6490
(813) 443-8143
Mailing address
2995 DREW ST FL 3, CLEARWATER, FL 33759-3012
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
06/29/2021
Last updated
06/29/2021
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